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Abstract
Objective To determine the effect of physician reporting laws and state licensing requirements on crash hospitalizations among drivers with dementia.
Methods A study of drivers hospitalized because of vehicle crashes, identified from the State Inpatient Databases of the Agency for Healthcare Research and Quality. Multivariable logistic regression was used to examine the effect of mandatory physician reporting of at-risk drivers and state licensing requirement on the prevalence of dementia among hospitalized drivers.
Results Physician reporting laws, mandated or legally protected, were not associated with a lower likelihood of dementia among crash hospitalized drivers. Hospitalized drivers aged 60 to 69 years in states with in-person renewal laws were 37% to 38% less likely to have dementia than drivers in other states and 23% to 28% less likely in states with vision testing at in-person renewal. Road testing was associated with lower dementia prevalence among hospitalized drivers aged 80 years and older.
Conclusion Vision testing at in-person renewal and in-person renewal requirements were significantly related with a lower prevalence of dementia in hospitalized older adults among drivers aged 60 to 69 years. Road testing was significantly associated with a lower proportion of dementia among hospitalized drivers aged 80 years and older. Mandatory physician driver reporting laws lacked any independent association with prevalence of dementia among hospitalized drivers.
Glossary
- AD=
- Alzheimer disease;
- AHRQ=
- Agency for Healthcare Research and Quality;
- CI=
- confidence interval;
- DSM-V=
- Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition);
- GEE=
- generalized estimating equation;
- HCUP=
- Healthcare Cost and Utilization Project;
- ICD-9-CM=
- International Classification of Diseases, Ninth Revision, Clinical Modification
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received May 29, 2017.
- Accepted in final form December 1, 2017.
- © 2018 American Academy of Neurology
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